Zinc sulfate treatment of secondary male infertility associated with positive serum and seminal plasma anti-sperm antibody test

ObjectiveThe traditional use of corticosteroids in the treatment of infertile patients who developed anti-sperm antibodies may be associated with many systemic side effects of such administered drugs. So the use of alternatives for corticosteroids becomes mandatory in order to minimize these systemic side effects. Like the use of immune modulator zinc sulfate.DesignProspective study.SettingInstitute of the Embryo Research and Infertility Treatment, College of Medicine, AL – Nahrain University.Patients and methodsForty-eight infertile men with poor semen parameters and elevated serum and seminal plasma level of ASA were classified into three groups. The first group (n = 18 patients) received oral zinc sulfate, the second group (n = 20 patients) received oral prednisolone and the third group (n = 10 patients) received oral placebo. Drugs were administered for 45 days.Main outcome measure(1) Standard semen analysis was performed, including semen volume, sperm concentration, percent motility, sperm vitality and sperm morphology. (2) Serum and seminal plasma Anti-Sperm Antibody ELISA test.ResultsStatistical analysis of serum and seminal plasma level of ASA reveals that the level is decreased significantly (P < 0.001, P < 0.002) in zinc sulfate treatment group as compared to the control group (67.5 ± 2.64 vs. 71.6 ± 2.5, 66.94 ± 3.24 vs. 71 ± 2.54), respectively, but the decrease in prednisolone treatment group is significantly higher (P < 0.001) as compared to the zinc sulfate treatment group (57.3 ± 6.30 vs. 67.5 ± 2.64, 56.5 ± 6.83 vs. 66.94 ± 3.24), respectively. This improvement in serum and seminal plasma level of ASA, result in a significant enhancement of the seminal fluid parameters including sperm concentration, sperm motility, vitality and normal sperm morphology in both zinc sulfate and prednisolone treatment groups.ConclusionIn conclusion, infertile men with elevated level of ASA and poor basic parameters of seminal fluid characters can be treated with zinc sulfate protocol with great chance for decreasing the level of serum and seminal plasma ASA, and alleviating the serious side effects associated with corticosteroids.